Medicaid Benefits for Resident Aliens Debated in Sixth Circuit

CINCINNATI (CN) – The Sixth Circuit heard arguments Tuesday over whether Michigan’s computer system glitches are still causing permanent resident aliens to be denied Medicaid benefits they are entitled to.

Aelen Unan and Patricia Quintino, a lawfully immigrated refugee and permanent resident alien, respectively, sued the state of Michigan after being denied full Medicaid benefits in 2014.

Unan and Quintino, along with thousands of others, were granted Emergency Services Only, or ESO, benefits because of glitches in the state’s computer system following the implementation of the ACA, also called “Obamacare.”

After being sued, Michigan’s Department of Human Services worked to fix the technical issues and granted full benefits to eligible applicants.

U.S. District Court Judge Marianne Battani dismissed Unan and Quintino’s class-action complaint earlier this year after she found their claims moot.

In her opinion, Judge Battani detailed Michigan’s efforts to correct flaws in its computer system that left thousands without comprehensive Medicaid coverage.

“Individuals found to have been eligible were given full benefits …additionally, over the remainder of 2014, DHS implemented a series of corrections to its system and ultimately re-processed thousands of individuals who had been assigned to Emergency Services Only benefits,” the judge wrote.

Battani concluded, “Ultimately, plaintiffs have failed to come forward with affirmative evidence of their own demonstrating the existence of individuals who were erroneously assigned to ESO because of systemic technical problems and who are therefore able to serve as potential class members. The most plaintiffs have shown is the fact that errors continue to occur but not the cause of these errors or that the rate of error is legally problematic.”

Despite having been granted full Medicaid coverage, Unan and Quintino appealed to the Sixth Circuit in hopes of winning prospective relief for people whose applications may be denied in the future because of similar computer errors.

Their attorney, Anna Marie Hill, admitted in a hearing Tuesday that there will always be errors of one kind or another, but said she is concerned about getting a “systemic solution” to the problems encountered by her clients.

Hill also argued that the plaintiffs’ discovery in the case was limited, which prevented them from getting to the root of the computer system issues.

Sixth Circuit Judge Jeffrey Sutton remarked that “[the state] seems to be fixing every major problem,” and then asked whether Hill made specific requests to extend discovery.

“We thought we made it clear to the district court that it was unfair to grant summary judgment [without more discovery],” Hill replied, although she also admitted she did not file a motion with the court.

Sutton called the lack of a motion “problematic,” and asked, “If you got everything you want, how does this case end?”

“[With] systemic issues fixed,” Hill replied.

“I love the word,” Sutton interjected before she could finish her statement, “But I need the meaning behind it. What error rate is okay?”

Hill concluded her arguments without a definitive answer, but said Unan and Quintino have been unable to get a conclusive error rate from the state.

Michigan Assistant Attorney General Joshua Smith argued that the class represented by the plaintiffs doesn’t exist anymore, and that the state’s computer system fix “mooted the class-wide relief.”

He told the panel that all of the reprocessing of Medicaid applicants who may have been misclassified to ESO benefits has been completed, and that Michigan is not simply “picking off” potential plaintiffs to prevent further litigation.

Smith disputed Unan and Quintino’s discovery claims, arguing, “Appellants’ counsel could not come up with any substantial reason to extend discovery.”

Sixth Circuit Judge Helene White questioned whether there were issues of material fact that should have prevented the dismissal of the case, specifically a series of emails between state employees that hinted at a system-wide issue in 2015.

“We provided over 18,000 documents and [the plaintiffs] found one unsubstantiated opinion [in that email]. I think it is insignificant,” Smith replied.

Sixth Circuit Judge Karen Nelson Moore rounded out the panel.

No timetable has been set for the appeals court’s decision.